[Clinical course and therapy of congenital malformations of the larynx]

Congenital anomalies of the larynx are reviewed from a clinical and therapeutic point of view by means of data from the literature and our own case studies. Laryngeal aplasia is not compatible with life, whereas atresia may have a theoretical chance to survive. Among the stenotic anomalies causing congenital stridor the harmless laryngomalacia is the most frequent. The subglottic hypoplastic ("hard") cricoid stenosis requires laryngoplasty , which may be done as early as the second year of life. In contrast, a subglottic hyperplastic ("soft") stenosis may resolve spontaneously during the first 3-5 years of life. Laryngeal webs and congenital synechiae of the vocal processes are resected endoscopically. A bilateral paralysis of vocal cords must be distinguished from congenital ankylosis of the cricoarytenoid joints by electromyography. If there is no spontaneous widening of the glottis during postnatal laryngeal growth, both diseases require endoscopic laterofixation of one vocal cord. Laryngoceles are mainly seen in adults, whereas congenital cysts are mostly observed in early childhood, especially when they are large enough to cause respiratory distress. Subglottic hemangiomas occur in two types: first, there is the cavernous hemangioma, which has to be surgically removed only in the case of respiratory inpediment , because it may recede spontaneously. Secondly, there is the submucosal flat hemangioma within the scope of congenital hemangiomatoses of the facial and cervical area, which probably does not cause a pseudocroup like syndrome without an additional upper respiratory tract infection. An intralaryngeal goitre is found almost exclusively in adults. The prognosis of a laryngoesophageal cleft is still very uncertain. We report such a case which demonstrates the difficulties of surgical repair. The term "dysplastic dysphonia" refers to congenital hoarseness due to minor defects or asymmetries of laryngeal structures such as the fairly frequent sulcus glottideus or the very rare anterior laryngeal cleft due to disturbed fusion of the thyroid cartilage plates.(ABSTRACT TRUNCATED AT 400 WORDS)